The bill Introduced Tuesday in Congress would set
aside $45 million in federal grants over seven years as seed money for
communities to design and implement local programs to provide health
insurance or health care services to the uninsured. There are 1.1
million uninsured people in Michigan.

"As we all know, there are way too many Americans who do not have
access to health insurance and therefore they do not have access to
health coverage," said U.S. Rep. Pete Hoekstra, R-Holland, the bill's
main sponsor.

"We also know that as we face this issue in health care, there's not a
silver bullet to address these concerns. We need to be doing a lot of
things in a lot of different areas."

Inspired by Muskegon's Access Health insurance program, the Communities
Building Access Act would allow communities to leverage federal grants
to create local health insurance cooperatives where the cost of care is
shared by the local government, employers and employees.

The money also could be used to create volunteer specialty provider
networks, in which providers discount their services to care for
low-income members of the network. CareNet of Toledo/Lucas County,
Ohio, is the most prominent example of such a network.

Vondie Woodbury, director of the Muskegon Community Health Project,
said that these community-based solutions are appealing to the business
community, which has been reluctant to embrace national solutions for
fear they would be costly and require too much red tape.

As commendable as these initiative may seem, they suffer from a serious
flaw. They rely on an unreliable patchwork of solutions.
The specifics vary from place to place, and change from time
to time. As a result, healthcare providers will have a hard
time understanding exactly what benefits are available, where, when,
and for whom. This will make it difficult for providers to
formulate treatment plans for their patients.

I understand what Woodbury said about the business community being
reluctant to embrace national solutions. They are afraid it
would be costly and require too much red tape. The solution
is not to create additional programs that add on to the programs that
are already available. It does not make any sense to think
that such an approach will reduce costs and avoid red tape.
The opposite is true. It is inevitable that
creating more programs will crate more overhead costs. The
only was to both increase overhead and decrease costs, is to limit the
care that is provided. The thing is, nobody wants to come
right out and say the truth. The truth is, it would cost a
lot of money to provide unlimited health care. The only
alternative is to ration the care in some way. But nobody
wants to talk about rationing health care.

So instead, what we have done, as a society, is to build a massively
inefficient, complex system that limits access to health care by being
so inaccessible and inscrutable that health care is effectively
rationed, without anyone having to say that it is rationed.

The only sensible approach is to have a universal system that provides
basic health care. If people want more, than what we, as a
collective, decide we can afford, then that can go out and pay for it
themselves. If we want to expand what is covered in the basic
package, then we have to decide to pay for it. But the key is
to keep the basic system as efficient as possible, with as little
paper-shuffling as possible.

If people want to pay others to move paper from one stack to another,
they are free to do so, but they have to pay for it themselves.
There is no reason to use collective funds to pay for that.

Some of these issues are discussed here,
specifically regarding the Massachusetts plan.

The link below goes to a dummy account that automatically forwards email to the Federal Trade Commission's spam reporting service. Don't use it unless
you are a robot. Instead, act like a human and figure out the real address from this: joseph/dot/j7uy5/at-sign/gmail/dot/com

The Corpus Callosum is an occasional journal of armchair musings, by an Ann Arbor reality-based, slightly-left-of-center regular guy who reserves the right to be highly irregular at times.
Topics: social commentary, neuroscience, politics, science news.
Mission: to develop connections between hard science and social science, using linear thinking and intuition; and to explore the relative merits of spontaneity vs. strategy.